title: Endovascular techniques in limb salvage: cutting, cryo, brachy, and drug-eluting balloons.
abstract: The complex pathophysiology response to injury of the lower-extremity arteries has prompted the development of several unique balloon technologies to overcome initial technical failures and short-term intimal hyperplasia. Cryoplasty alters the cellular and mechanical properties of the vessel wall during angioplasty. Cutting balloons incise the wall, preventing elastic recoil and allowing expansion of the lumen at a lower pressure, thus limiting barotrauma. Drug-eluting balloons actively transfer inhibitory compounds to the wall during the initial therapy, while brachytherapy balloons allow for localized delivery of radiation to inhibit the proliferative response seen after angioplasty. These platforms provide unique means to enhance immediate and short-term results and also reduce stent usage in the lower extremity.
authors.affiliation: Methodist DeBakey Heart & Vascular Center, The Methodist Hospital, Houston, Texas, USA.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Davies
authors.forename: Javier E
authors.initials: JE
authors.lastname: Anaya-Ayala
mesh_terms: D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D001918:Brachytherapy / Q000009:adverse effects / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D017679:Cryotherapy / Q000009:adverse effects / Q000295:instrumentation*; D004337:Drug Carriers; D004867:Equipment Design; D006439:Hemodynamics; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012039:Regional Blood Flow; D016896:Treatment Outcome; D062666:Vascular Access Devices
chemical_list: D002317:Cardiovascular Agents; D004337:Drug Carriers
keywords: balloon angioplasty; brachytherapy balloon; critical limb ischemia; cryoplasty; cutting balloon; drug-eluting balloon; lower extremity intervention; percutaneous transluminal angioplasty; restenosis